Organization
ADVANCED LIPEDEMA TREATMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CANDICE MARIE FURLONG (BILLING REPRESENTATIVE)
(626) 331-6170
Entity
Organization
Contact information
Practice address
450 N ROXBURY DR STE 400, BEVERLY HILLS, CA 90210-4218
(424) 394-1610
(424) 394-1628
Mailing address
450 N ROXBURY DR STE 400, BEVERLY HILLS, CA 90210-4218
(424) 394-1610
(424) 394-1628
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
01/30/2023
Last updated
01/30/2023
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